Objective To evaluate whether perturbed concentrations of serum β2 - microglobulin (β2 - MG) and cystatin C ( CYS C) due to renal damage can accurately reflect liver diseases in different stages. Methods Between 2010 and 2011 , 125 consecutive patients diagnosed with hepatitis B virus (HBV) infection were enrolled for study, including 55 patients with chronic hepatitis, 38 patients with cirrhosis , and 32 cases of chronic severe hepatitis; patients were tested to rule out other diseases that may cause elevated β2 - MG and/or CYS C. Fifty - five healthy individuals were recruited for the control group. After an 8 h fast, measurement of serum β2 - MG and CYS C was made by the latex - enhanced turbidimetric immunoassay, and of serum creatinine (SCr) by enzymatic assay. Significance of intergroup differences was assessed by the statistical t - test. Results As compared to the control group, the chronic hepatitis group showed similar levels of serum CYS C ((0.86 ±0. 23)mg/L vs. (0.90 ±0. 28) mg/L, t=0.82, P>0.05) , but significantly enhanced serum β2 - MG ((1.02 ± 0.89)mg/L vs. (1.35 ±0.78)mg/L, t=2.07, P<0.05). However, both the liver cirrhosis and severe hepatitis groups showed significantly enhanced levels of serum CYS C (vs. cirrhosis; (1. 35 ±0. 38) mg/L, t =7.75 , P <0.01 ; severe hepatitis; (3. 02 ±1. 56) mg/L, t = 10. 12, P<0.01) and β2 - MG (cirrhosis; (2. 35 ± 1.23) mg/L, t = 6. 05 , P <0. 01; severe hepatitis; (4.35 ±0.98) mg/L, t = 16. 21 , P <0. 01). Only the severe hepatitis group showed a significant difference (enhanced) in levels of SCr as compared to the control group ((128±38)μmol/L vs. (82 ±23) μmol/L, t =7. 04, P <0.01). Conclusion Levels of serum CYS C and 32 - MG are enhanced during hepatitis and may be a useful diagnostic indicator of early liver disease with greater sensitivity than SCr. Although serumβ2 - MG was more sensitive than CYS C, its concentration may be affected by more factors, so the measurement of both β2 - MG and CYS C may be necessary when developing an effective clinical or investigative method to monitor the course of renal damage caused by liver diseases.%目的 通过联合检测血清胱抑素C(CYS C)和β2-微球蛋白( β2-MG)的浓度水平,判断其对不同时期肝病引起的肾功能损害的诊断价值.方法 采用胶乳增强免疫比浊法诊断试剂测定125例不同时期(慢性肝炎、肝硬化、重型肝炎)肝病患者血清中CYS C、β2-MG和肌酐含量,并对这三项指标的测定结果与55例健康对照组结果进行比对分析.结果 慢性肝炎组CYS C测定结果与对照组间差异无统计学意义,而β2-MG在此阶段与对照组间差异有统计学意义.肝硬化与重型肝炎患者的CYS C和β2-MG测定结果与对照组间差异均有统计学意义.肌酐测定结果在慢性肝炎组、肝硬化组与对照组比较,差异均无统计学意义,而在重型肝炎阶段与对照组比较差异有统计学意义.结论 β2-MG和血清CYS C比血清肌酐更为敏感,可更准确地反映肝病早期肾功能损害情况.β2-MG对于早期肝病导致肾损伤的检测灵敏度高于CYS C,但β2-MG浓度水平受到更多因素的影响,因此二者的联合测定对肝病引起的肾功能损伤病程具有良好的监测作用.
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